Jimerson, Tracy Lynn
Jimerson, Tracy Lynn is an individual health care provider with primary practice located at 3650 Steve Reynolds Boul Pediatrics Health Care Team A, Duluth GA 30096. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Jimerson, Tracy Lynn can be contacted via phone (770) 931-6012.Contact Information
Primary practice address
3650 Steve Reynolds Boul Pediatrics Health Care Team A
Duluth GA 30096
Phone: (770) 931-6012
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 35081121 | Ohio |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 057661 | Georgia |
Profile Details
| NPI number | 1669467379 |
|---|---|
| LBN Legal business name | Jimerson, Tracy Lynn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669467379 | NPPES |
| Ohio | MEDICAID | 2388036 |
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